孤立性眩晕起病的后循环缺血性脑卒中患者临床分析

Clinical analysis of patients with posterior circulation ischemic stroke with isolated vertigo

目的探讨后循环缺血性脑卒中的患者中最初仅表现为孤立性眩晕的患者的临床特点。方法回顾性分析阜新市中心医院2018-08—2019-08以孤立性眩晕起病的后循环缺血性脑卒中患者13例,对13例以孤立性眩晕起病的后循环缺血性脑卒中患者的危险因素、临床表现、磁共振特点及预后进行回顾性分析。结果13例患者的发病危险因素主要以糖尿病、高血压及脑血管病为主,大部分患者存在吸烟或饮酒的不良嗜好,仅1例患者无任何危险因素;所有患者均表现为头晕或眩晕,典型旋转性眩晕患者占69%,非旋转性眩晕(头晕)占31%,伴随症状中以呕吐和走路不稳更为常见,还有部分患者会有出汗、头痛及排便等情况;13例患者均行磁共振检查,DWI均出现责任病灶,其中小脑梗死8例,其余均为脑干梗死;13例患者均给予双重抗血小板、强化降脂及改善脑供血治疗,大部分患者预后良好;3例患者病情逐渐进展,预后不佳,其中死亡1例。结论后循环缺血性脑卒中患者若最初仅表现为孤立性眩晕容易误诊,早期应及时行磁共振检查,早诊断,早治疗。

Objective To investigate the clinical characteristics of isolated vertigo in patients with posterior circulation ischemic stroke.Methods A retrospective analysis was conducted on 13 patients with posterior circulation ischemic stroke with isolated vertigo in Fuxin Central Hospital from August 2018 to August 2019.The risk factors,clinical manifestations,MRI features and prognosis of 13 patients with isolated vertigo were retrospectively analyzed.Results It was found that the main risk factors of 13 patients were diabetes,hypertension and cerebrovascular disease.Most of the patients had bad habits of smoking or drinking,and only one patient had no risk factors.All patients presented with dizziness or vertigo,with 69%of patients with typical rotational vertigo and 31%with non rotating vertigo(dizziness).The accompanying symptoms were vomiting and walking instability MRI was performed in 13 patients,including 8 patients with cerebellar infarction and brainstem infarction;13 patients were treated with dual antiplatelet therapy,intensive lipid-lowering therapy and improvement of cerebral blood supply,most of them had good prognosis;3 patients had progressive disease and poor prognosis,One case died.Conclusion Early diagnosis and early diagnosis of ischemic vertigo should be done early.